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Effectiveness of exercise interventions for adults over 65 with moderate-to-severe dementia in community settings: a systematic review

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Key summary points

AbstractSection Aim

To review the literature on the effectiveness of exercise interventions for people with moderate-to-severe dementia in community settings.

AbstractSection Findings

The literature was of low quality, but suggested exercise programmes may improve physical function of people with moderate-to-severe dementia. There was no evidence that exercise programmes improve mood.

AbstractSection Message

More research is needed to improve the quality of the evidence to better understand the effectiveness of exercise programmes in community-dwelling older people with moderate-to-severe dementia.

Abstract

Purpose

To conduct a systematic review of the literature to evaluate the effectiveness of exercise interventions for people with moderate-to-severe dementia in community settings.

Methods

Eight electronic databases (MEDLINE, Embase, CINAHL, AMED, PsycINFO, PEDro, The Cochrane Library and BNI) were searched from inception to July 2018. Snowball searching identified additional articles not identified initially. Articles were included if they: reported randomised or quasi-randomised controlled trials comparing exercise with usual care or no treatment; and involved people over 65 with moderate-to-severe dementia in community settings. Outcome measures of interest were strength, endurance, mobility, mood and quality of life. Titles and abstracts of all studies were screened by one reviewer. Two reviewers independently screened full text articles for all eligible studies, extracted data and assessed quality and risk of bias.

Results

Eight studies with 819 participants were included. Interventions were variable in terms of content, duration and frequency. There was some evidence exercise programmes may improve physical function of people with moderate-to-severe dementia, with significant effects seen for gait speed and endurance, and a trend towards improvement in strength. There was little evidence to suggest exercise programmes improve mood. Most studies were of low quality.

Conclusion

Exercise was associated with improvements in gait speed and endurance for older people with moderate-to-severe dementia living in the community, but the quality of evidence was low. There was no conclusive evidence regarding effect on strength or mood. Findings are limited by the quality of the available evidence.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Division of Rehabilitation and Ageing, School of Medicine, B109, Medical School, Queen’s Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK

    Annabelle Long

  2. Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK

    Katie Robinson

  3. East Midlands Collaboration for Leadership in Applied Health Research and Care (EM-CLAHRC), Nottingham, UK

    Katie Robinson & Adam L. Gordon

  4. School of Health Sciences, University of Nottingham, Nottingham, UK

    Sarah Goldberg

  5. Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK

    Adam L. Gordon

  6. University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK

    Adam L. Gordon

Authors
  1. Annabelle Long
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  2. Katie Robinson
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  3. Sarah Goldberg
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  4. Adam L. Gordon
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Contributions

All authors wrote the protocol for the review, contributed to the analysis and wrote the manuscript. AL and KR conducted the review and led the analysis.

Corresponding author

Correspondence to Annabelle Long.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Long, A., Robinson, K., Goldberg, S. et al. Effectiveness of exercise interventions for adults over 65 with moderate-to-severe dementia in community settings: a systematic review. Eur Geriatr Med 10, 843–852 (2019). https://doi.org/10.1007/s41999-019-00236-7

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  • DOI: https://doi.org/10.1007/s41999-019-00236-7

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